<?php echo $header; ?>


		  <!-- Start - Left Side -->
	      <div id="left" class="span-24 ">
	      	<div id="account_address" class="span-24 checkout">
	    		<div class="heading_x span-24 ">
					<span><?php echo $heading_title; ?></span><hr />
			</div>
	    		 <form action="<?php echo str_replace('&', '&amp;', $action); ?>" method="post" enctype="multipart/form-data" id="address">
		&nbsp;
      <div class="content cufon success_content">
        <table>
          <tr>
            <td width="150" class="tb_label"><span class="required"><img src="./catalog/view/theme/galib/image/require.png" /> </span> <img src="./catalog/view/theme/galib/image/label_name.png" /></td>
            <td><input type="text" name="firstname" value="<?php echo $firstname; ?>" />
              <?php if ($error_firstname) { ?>
              <span class="error"><?php echo $error_firstname; ?></span>
              <?php } ?></td>
          </tr>
          <tr>
            <td class="tb_label"><span class="required"><img src="./catalog/view/theme/galib/image/require.png" /> </span> <img src="./catalog/view/theme/galib/image/label_lastname.png" /></td>
            <td><input type="text" name="lastname" value="<?php echo $lastname; ?>" />
              <?php if ($error_lastname) { ?>
              <span class="error"><?php echo $error_lastname; ?></span>
              <?php } ?></td>
          </tr>
          
          <tr>
            <td class="tb_label"><span class="required"><img src="./catalog/view/theme/galib/image/require.png" /> </span><img src="./catalog/view/theme/galib/image/label_address.png" /></td>
            <td><input type="text" name="address_1" value="<?php echo $address_1; ?>" />
              <?php if ($error_address_1) { ?>
              <span class="error"><?php echo $error_address_1; ?></span>
              <?php } ?></td>
          </tr>
			
        
          
           <tr>
            <td></td>
            <td><input type="text" name="address_2" value="<?php echo $address_2; ?>" />
             </td>
          </tr>
          
          <tr>
            <td></td>
            <td><input type="text" name="address_3" value="<?php echo $address_3; ?>" />
             </td>
          </tr>
                  
          <tr>
            <td class="tb_label"><?php echo $entry_postcode; ?></td>
            <td><input type="text" name="postcode" value="<?php echo $postcode; ?>" />
			  <?php if ($error_postcode) { ?>
              <span class="error"><?php echo $error_postcode; ?></span>
              <?php } ?></td>
          </tr>
		  <tr>
            <td class="tb_label"><?php echo $entry_default; ?></td>
            <td><?php if ($default) { ?>
              <input type="radio" name="default" value="1" checked="checked" />
              <?php echo $text_yes; ?>
              <input type="radio" name="default" value="0" />
              <?php echo $text_no; ?>
              <?php } else { ?>
              <input type="radio" name="default" value="1" />
              <?php echo $text_yes; ?>
              <input type="radio" name="default" value="0" checked="checked" />
              <?php echo $text_no; ?>
              <?php } ?></td>
          </tr>
        </table>
      </div>
	  <!-- not used field -->
	  <input type="hidden" name="company" value=""/>
	  
	  <input type="hidden" name="city" value=""/>
	  <input type="hidden" name="country_id" value=""/>
	  <input type="hidden" name="zone_id" value=""/>
	  
	  
	  <!-- /not used field -->
      <div class="buttons">
      	<div class="galib_btn1">
            		<a onclick="location = '<?php echo str_replace('&', '&amp;', $back); ?>'"><span><?php echo $button_back; ?></span></a>
        </div>
        <div class="galib_btn1 float_right">
            		<a onclick="$('#address').submit();"  style="float:right"><span><?php echo $button_continue; ?></span></a>
    	</div>
       	
        
      </div>
	  
    </form>
  			</div> 
	      </div>
       	 <!-- End - Left Side -->
       	 
       	 


<?php echo $footer; ?> 
<script type="text/javascript"><!--
$('select[name=\'zone_id\']').load('index.php?route=account/address/zone&country_id=<?php echo $country_id; ?>&zone_id=<?php echo $zone_id; ?>');
$('#postcode').load('index.php?route=account/address/postcode&country_id=<?php echo $country_id; ?>');
//--></script>


